Culture in Medicine and Healthcare

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The First-phase of our Research Work – Does culture influence the consultation?

Our first research project in 2001 was born out of this shared curiosity. We looked firstly at how culture might affect the doctor-patient relationship and management of consultations in general practice – did the outcome of the consultation vary when the doctor and patient came from different cultures when compared with consultations where doctor and patient were from the same culture? We observed and video recorded over 150 consultations in different locations in Pakistan and London, observing doctors working with patients in ‘cross –culture’ and ‘same culture’ situations. We then conducted in-depth and focus group interviews of doctors and patients, and analysed emergent themes from these consultations. A significant outcome of our project was that culture did appear as a factor that influenced the outcome of the consultation. For example, one consistent theme emerging showed us of thethat Asian patients have very different expectations of their doctor’s role in the consultation when compared with their British counterparts – preferring their doctor to be authoritarian, directive, and overly investigative – and we admired the adaptive skill of our overseas colleagues working in London, who, like chameleons, moved between consultation styles to meet the needs of both Asian and white-British patients.

The second-phase of our research project: Does culture influence learning and professional development?

The observations stemming from the cross-cultural consultation project inevitably led us to widen our interest in exploring cultural influences on healthcare. Majid’s own experience of being one of only two overseas students in a British Master’s Programme, alongside Rosslynne’s experience of working internationally as a medical educator, heightened our inquisitiveness about the influence of culture on learning, and led us to think more about how culture might impact on the way in which we approach learning and assessment. If culture affects the learning process, then how might an international medical graduate, educated outside of the UK, perceive a training programme – and within it, the role of a teacher and educational supervisor? Might their expectations and perceptions of these central roles be different from those of their teachers and assessors? If so – what should be done to address the situation? From our work on these themes, we consider that culture is indeed a factor influencing both learner-teacher interaction, and how learners approach using assessment tools, and, in turn, influences future professional development.